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CC BY-NC-ND 4.0 · AJP Rep 2020; 10(03): e288-e293
DOI: 10.1055/s-0040-1716732
Case Report

Infective Endocarditis as a Complication of Intravenous Drug Use in Pregnancy: A Retrospective Case Series and Literature Review

Adebayo Adesomo
1   Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio
,
Veronica Gonzalez-Brown
1   Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio
,
Kara M. Rood
1   Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio
› Author Affiliations Funding The authors report no external funding source for this study.
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Abstract

Objective An increase in opioid use disorder and subsequent intravenous drug use has led to an increase in sequalae that may complicate pregnancy, such as infective endocarditis. Infective endocarditis has the potential for significant maternal and neonatal morbidity and mortality. We sought to examine the management considerations and clinical implications of intravenous drug use-related infective endocarditis in pregnancy from our center's experience.

Study Design Retrospective study of management of pregnancies complicated by infective endocarditis as a result of active intravenous drug use at an academic tertiary care hospital from January 2012 through December 2019.

Results Twelve women with active intravenous drug use histories were identified as having clinical and echocardiographic features consistent with infective endocarditis. Six women were discharged against medical advice and did not complete the full course of recommended antibiotic regimen. Eight women were started or continued on opioid agonist therapy during their hospitalization. Four neonates required neonatal intensive care unit admission for pharmacologic treatment for neonatal abstinence syndrome.

Conclusion Management of intravenous drug use-associated infective endocarditis in pregnancy involves more than treating the acute condition. In pregnant women with opioid use disorder and infective endocarditis, addiction and chronic psychosocial conditions need to be addressed to optimize care.

Keywords

infective endocarditis - pregnancy - intravenous drug use - bacteremia - opioid use disorder


Publication History

Received: 20 March 2020

Accepted: 04 June 2020

Article published online:
23 September 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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